Eight plate should not be used for treating leg length discrepancy

Lauge-Pedersen, Henrik; Hägglund, Gunnar

doi:10.1007/s11832-013-0506-7

Cited by 39 publications

(42 citation statements)

References 17 publications

(16 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As the guided implantation technique and a reduced number of implants have been shown to be advantageous over BS, their range of indication was extended to TTE for LLD correction. Unfortunately, the biomechanical behavior of flexible implants does not seem appropriate for TTE and may lead to central joint deformations and insufficient growth arrest . Rigid implants such as BS seem to provide a more suitable, evenly distributed growth arrest throughout the entire physis.…”

Section: Discussionmentioning

confidence: 99%

“…Good results without relevant implant‐associated problems were reported when using the device for correction of AD, and as a consequence, its range of indication was extended to the treatment of moderate LLD . Unfortunately, the biomechanical behavior of flexible implants can result in problems such as inefficient growth arrest and central joint deformations …”

mentioning

confidence: 99%

See 1 more Smart Citation

Comparison of Temporary Epiphysiodesis With RigidTacks™ and Blount‐Staples in a Porcine Animal Model Using Magnetic Resonance Imaging

Hillebrand

Sattelberger

Gosheger

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

RigidTack™ is a newly developed implant for total temporary epiphyseodesis. The implant combines the technical advantages of the traditionally used rigid Blount-staples and the newer flexible eight-plates™. Thus, the implant is rigid like the Blountstaples, which may be a biomechanical advantage in temporary epiphyseodesis, and has an easy and guided implantation technique like the eight-plate™. As in eight-plates™, supposedly only two RigidTacks™ are sufficient for temporary epiphyseodesis compared to six Blountstaples in traditional treatment. The goal of this study was to compare Blount-staples and RigidTacks™ in regard to the total potential of growth arrest, the occurrence of postoperative implant-associated complications, secondary angular deformities, and central joint deformations. Twelve pigs were allocated in two groups (n = 6) for treatment of the proximal tibia. Total temporary epiphysiodesis was performed with either four Blount-staples or two RigidTacks™. Magnetic resonance imaging (MRI)-scans were performed before and 14 weeks after surgery, and the amount and distribution of growth arrest were evaluated by measuring the interphyseal distance in nine defined zones. Total temporary epiphysiodesis with two RigidTacks™ resulted in a similar amount of growth arrest as that of four Blount-staples. No significant coronal or sagittal angular deformities or joint deformities were observed in either group; however, one secondary loosening of a Blount-staple occurred. The study concluded that Blount-staples and RigidTacks™ are adequate implants for total temporary epiphysiodesis. Whether or not the precise implant-placement through the guided implantation technique of RigidTacks™ and a reduced number of implants indeed lead to a reduction of secondary angular deformities has to be investigated in further clinical trials.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Comparison of Temporary Epiphysiodesis With RigidTacks™ and Blount‐Staples in a Porcine Animal Model Using Magnetic Resonance Imaging

Hillebrand

Sattelberger

Gosheger

et al. 2019

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…We performed an animal experimental study suggesting that temporary epiphysiodesis using tension band plating implants was feasible [23]. Clinical papers have now emphasised the problems arising with the clinical use of this technique which include failure of epiphysiodesis and problems with uncontrolled growth [24, 25]. …”

Section: Tension Band Platingmentioning

confidence: 99%

Guided growth: Mechanism and reversibility of modulation

Gottliebsen

Shiguetomi-Medina

Rahbek

et al. 2016

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

In paediatric orthopaedics, deformities and discrepancies in length of bones are key problems that commonly need to be addressed in daily practice. An understanding of the physiology behind developing bones is crucial for planning treatment. Modulation of the growing bone can be performed in a number of ways. Here, we discuss the principles and mechanisms behind the techniques. Historically, the first procedures were destructive in their mechanism but reversible techniques were later developed with stapling of the growth plate being the gold standard treatment for decades. It has historically been used for both angular deformities and control of overall bone length. Today, tension band plating has partially overtaken stapling but this technique also carries a risk of complications. The diverging screws in these implants are probably mainly useful for hemiepiphysiodesis. We also discuss new minimally invasive techniques that may become important in future clinical practice.

show abstract

“…The clinical outcome for this indication ranges from efficient to not effective . A case report even recommends not to use this implant for LLD treatment . The reasons for the variation in the clinical experience may stem from the incomplete understanding of the biomechanical effect of the implant treatment on the growing bone and vice versa.…”

mentioning

confidence: 99%

Biomechanical investigation of two long bone growth modulation techniques by finite element simulations

Schneider

Buschbaum

Joeris

et al. 2017

Journal Orthopaedic Research

View full text Add to dashboard Cite

Implants used to correct pathological varus-valgus deformities (VVD) and leg length discrepancies (LLD) may not be optimized for the specific treatment, as suggested by their off-label use. Detailed analysis of this issue has been limited by the poorly understood mechanical behavior of the growing physis and ignorance of the loads acting on the implants. The aim of this study was to predict and compare the loading conditions of a growth modulation implant in VVD and LLD treatments. Idealized finite element (FE) models of the juvenile distal femur treated with the Eight-Plate implant were developed for VVD and LLD. Bone growth was simulated using thermal strains. The axial force in the plate was compared between the two treatments. Case-specific plate forces were predicted by virtually reproducing the screw deformation visible on radiographs of LLD (N = 4) and VVD (N = 4) clinical cases. The simple FE models reproduced the clinical implant deformations well. The resulting forces ranged from 129 to 580 N for the VVD patients. For LLD, this range was from 295 to 1002 N per plate, that is, 590-2004 N for the entire physis. The higher forces in LLD could be explained by restricted screw divergence in the double-sided implant application. For the first time, the loading conditions of a growth modulation implant were investigated and compared between two treatments by FE analyses, and the range of case-specific loads was predicted. These simulation tools may be utilized for guiding appropriate usage and for efficient development of implants. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1398-1405, 2018.

show abstract

Eight plate should not be used for treating leg length discrepancy

Cited by 39 publications

References 17 publications

Comparison of Temporary Epiphysiodesis With RigidTacks™ and Blount‐Staples in a Porcine Animal Model Using Magnetic Resonance Imaging

Comparison of Temporary Epiphysiodesis With RigidTacks™ and Blount‐Staples in a Porcine Animal Model Using Magnetic Resonance Imaging

Guided growth: Mechanism and reversibility of modulation

Biomechanical investigation of two long bone growth modulation techniques by finite element simulations

Contact Info

Product

Resources

About